- Design
- Systematic review and meta-analysis of prevalence studies
- Population
- 207 studies; 134,071 trans and gender diverse adults in 52 countries
- Primary outcome
- Prevalence of mental disorders, suicidality and non-suicidal self-injury
- Effect
- Depression 40.1% (35.6 to 44.8); past-year suicidal ideation 43.1% (38.9 to 47.3); suicide attempt 9.3% (7.7 to 11.0)
A systematic review and meta-analysis in Psychological Medicine, published on 8 October, pooled 207 studies covering 134,071 trans and gender diverse adults in 52 countries, excluding highly selected samples other than gender-affirming clinics.
Pooled prevalence was 40.1% (95% CI 35.6 to 44.8) for depression, 29.8% for anxiety and 23.6% for post-traumatic stress disorder, combining screening-threshold and diagnosed cases. In the past 12 months, 43.1% reported suicidal ideation, 9.3% a suicide attempt and 26.1% non-suicidal self-injury. Limited data suggested higher figures in non-binary participants.
The estimates varied substantially with how mental health was measured, where participants were recruited and which region they came from, so a single pooled number should not be read as the rate in any one clinic. The direction, however, is consistent and well above general-population estimates.
For a clinician, the practical implication is routine, direct suicide risk enquiry and screening for depression and PTSD when a trans or gender diverse adult presents for any reason, delivered in a way that does not make gender identity itself the presumed problem.
- Ask directly about suicidal thoughts and recent self-harm when assessing a trans or gender diverse adult, whatever the presenting complaint.
- Screen for depression, anxiety and post-traumatic stress disorder; each was common in the pooled data.
- Use the patient's chosen name and pronouns in notes and conversation — engagement depends on it.
- Ask about non-binary identity specifically; limited data suggested a higher burden in this group.
- Record past-year self-harm separately from suicide attempts; both were common.
Why it matters
With past-year suicidal ideation near 43% in pooled data, a risk question here is routine care, not an exception.
Don't overread it
Pooled prevalence varied widely by method and setting; it is not the rate in any single service.
The statistics, in plain English
The 95% CI for depression (35.6% to 44.8%) is narrow, so the pooled estimate is fairly precise. Wider intervals for anxiety and PTSD, and large differences between studies, mean those figures depend heavily on how and where people were assessed.
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